The chief psychiatrist of Victoria, Australia, has just published their annual report covering the period 2011-12. It shows that during the year 1,688 patients received a total of 18,803 treatments. This is a very high use of ECT (compared to, say, Scotland). It is not possible to say, from the figures given in the report, how much the high number of treatments per person (over 11) is accounted for by large numbers of people receiving maintenance ECT, by large numbers of treatments per course, or by people receiving multiple courses of ECT during the year.
Both the figures for the total number of treatments and the number of patients were slightly down on the previous year’s figures. But the use of ECT on people under the age of 20 had more than doubled from 86 treatments to 194 (all of them given to people aged between 17 and 19).
In the public sector 1,056 patients received 11,589 treatments; in the private sector 632 patients received 7,214 treatments. The report says:
“As in 2010–11, sixty-five per cent of all ECT treatments were administered to patients who had consented to their own treatment; and 35 per cent to involuntary patients, where the authorised psychiatrist consented on their behalf. Involuntary treatment can only occur in a public mental health service proclaimed under the Act.”
If this means what it says, then over half of ECT in the public sector in Victoria is being given without a patient’s consent. Another surprising figure in the report is that about 20 per cent of treatments were for a diagnosis of schizophrenia.
The Victorian department of health remains unconvinced by ultra-brief pulse ECT, which, incidentally, is not a new treatment, having first been tried in the 1940s. The report says:
“Ultra–brief pulse ECT is a new method of delivering ECT and there is some evidence of its potential to minimise possible side-effects of ECT, such as temporary memory loss [isn’t that rather a lot of qualifiers for one sentence?]. This method of providing ECT was again discussed by the ECT subcommittee of the QAC in 2011–12. The majority view remained that the method has not yet been adequately evaluated and needs a stronger evidence base before it can be accepted for routine use in the public sector.”